This is an automatically translated article.
Article by Pharmacist Nguyen Thi Thanh Nga - Clinical Pharmacist - Faculty of Pharmacy - Vinmec Times City International Hospital
Tarceva® has the active ingredient erlotinib and is indicated for the treatment of pancreatic cancer. To ensure the effectiveness of treatment and avoid unwanted side effects, patients need to use drugs according to prescription or under the direction of a doctor or pharmacist.
1. What is Tarceva®?
The active ingredient of Tarceva® is erlotinib. This is a tyrosine kinase inhibitor drug, first approved by the US Drug Administration in 2004 for the treatment of non-small cell lung cancer. In 2005, the drug was approved for use in combination with gemcitabine in the treatment of locally advanced or inoperable pancreatic cancer or metastatic pancreatic cancer.2. What is the role of Tarceva® in the treatment of pancreatic cancer?
Pancreatic cancer is a malignancy that often responds poorly to chemotherapy. In the past, gemcitabine alone has been used as standard treatment since the 2000s due to its ability to significantly improve survival compared with previous drugs. The 1-year survival rate was 24% (compared to 5% in the 5-fluorouracil group) with a longer median survival of 5.65 months.
Patients with pancreatic cancer often have epithelial growth factor receptor (HER1/EGFR) overexpression and this leads to a poor prognosis. Erlotinib is a small molecule tyrosine kinase inhibitor that inhibits epithelial growth receptor (EGFR) - a biological target that plays an important role in the pathogenesis of pancreatic cancer.
Research by the Canadian authors published in 2007 has shown that the group of patients who used erlotinib in combination with gemcitabine had a longer survival time, a higher 1-year survival rate, and a progression-free survival time. disease was longer than in the gemcitabine group alone. The difference is not too big but is statistically significant and proves the superior effect of the drug combination compared to using gemcitabine alone. However, the quality of life in the two groups surveyed through the questionnaire was not statistically significant, the group using 2 combination drugs had a decrease in quality of life score due to diarrhea side effects.
Although there are no specific evaluation guidelines, post-study analyzes suggest that patients who develop a rash within the first 4 to 8 weeks after treatment have a longer prognosis than patients who do not. rash (median survival 7.2 months versus 5 months). Patients with lower baseline pain scores appear to benefit more from Tarceva ®. Your doctor will evaluate before treatment and during treatment to advise you.
Thuốc Tarceva có kết quả tốt trong điều trị ung thư tuyến tụy
3. Usage and dosage of Tarceva® in the treatment of pancreatic cancer?
Tarceva® is used at a dose of 100mg/day, in combination with gemcitabine according to the regimen in the treatment of locally advanced, inoperable or metastatic pancreatic cancer.
The drug is taken on an empty stomach, 1 hour before meals or 2 hours after meals. If you forget your medication, take it as soon as you remember. If it's too close to the time of your next dose, just take the next dose, do not take a double dose.
Your dosage may be changed in some special cases based on response to medication, smoking status and adverse effects.
4. Possible side effects when using Tarceva®?
Not all patients experience side effects from medications and not all side effects happen to you. During the course of taking the drug, you may feel fatigue, nausea, vomiting, loss of appetite, gastrointestinal irritation, diarrhea, rash, cough, weight loss...
When you feel digestive irritation , vomiting or diarrhea, talk to your doctor for advice. Your doctor may prescribe some medications to help or reduce unwanted effects.
Rash can occur in up to 90% of patients within 4 - 8 weeks of using Tarceva ® , however, when the rash is too severe or persistent, you need to notify your doctor immediately. When there is a skin lesion in the form of blisters, peeling, redness of the whole body, with or without mouth ulcers and natural cavities, you need to go to the hospital for a timely examination and evaluation.
The drug can cause gastrointestinal perforation, affecting the liver, kidneys, lungs, eyes to varying degrees. Therefore, to ensure safe and effective medication use, you need to follow the treatment as prescribed and have regular check-ups for evaluation. Before treatment with Tarceva®, your doctor will check your liver and kidney function, electrolytes, and eye exams. During treatment, you will be periodically checked for liver and kidney function, electrolytes and eye exams after 4-8 weeks of taking the drug.
Immediately notify your doctor or go to the nearest medical facility if there are serious abnormalities such as yellowing of the skin and eyes, changes in vision, difficulty breathing, severe abdominal pain, vomiting blood, black stools. , severe, persistent diarrhea, little urine or anuria...
Người bệnh có thể cảm thấy mệt mỏi khi sử dụng thuốc Tarceva
5. Precautions when using Tarceva®
You need to talk to your doctor about your medical history and current medications before you start taking them. Tarceva ® may interact with many medications including over-the-counter medicines, vitamins and supplements, herbs. This can affect the effectiveness of the drug or increase the risk of side effects or toxicity. Therefore, during treatment, you need to talk to your doctor when you need to use any more drugs.
If you are taking a vitamin K antagonist anticoagulant such as warfarin, acenocoumarol, your doctor may recommend regular visits and dose adjustments as well as closer monitoring when starting or stopping the drug. Tarceva ® may increase the INR and risk of bleeding when used concomitantly with these anticoagulants.
Smoking can reduce the concentration of Tarceva ® in the blood, leading to a decrease in its effectiveness. You should talk to your doctor about smoking before starting treatment. Usually, you will be advised by your doctor to quit smoking for the best treatment effect. In case you are unable to quit smoking, your dose of Tarceva ® may be increased compared to a non-smoker. Your dose will be gradually increased over time, you need to follow the instructions and prescriptions of your doctor exactly. You should tell your doctor right away when you start to stop smoking or start smoking again.
In case you need to use drugs to protect the stomach or reduce gastric acid secretion, you need to talk to your doctor for advice and choose the right drug with a reasonable interval between these drugs and Tarceva. ® . Drugs that reduce gastric acid secretion may reduce the concentration of the drug absorbed and decrease the effectiveness of the drug. Therefore, arbitrarily using drugs to reduce gastric acid secretion without the guidance of a specialist will affect the effectiveness of treatment and your health.
Sun exposure can cause or worsen skin reactions. During use of the drug, your skin is also sensitive to the sun and more susceptible to sun damage. Therefore, you should avoid direct sun exposure. At the same time, you should use protective gear and sunscreen when outdoors.
Tarceva ® can affect the fetus, women of childbearing age should avoid pregnancy during treatment until at least 1 month after the last dose.
There are insufficient data on the safety of use in nursing women. To ensure the safety of breast-feeding, you need to avoid breast-feeding while taking this medicine until at least 2 weeks after the last dose.
During treatment with Tarceva ® , you need to eat and drink enough, maintain an adequate amount of water to avoid dehydration, especially when you have diarrhea.
Keeping your mind at ease, getting enough sleep, exercising moderately, complying with treatment and having regular or scheduled follow-up visits will help you get the most effective and safest treatment. Do not stop taking your medicine or change the dose on your own without consulting your doctor. Talk to your doctor about any unusual discomforts during your visits for advice and timely treatment.
Tarceva® has the active ingredient erlotinib and is indicated for the treatment of pancreatic cancer. To ensure the effectiveness of treatment and avoid unwanted side effects, patients need to take the drug as prescribed or under the direction of a doctor or pharmacist.
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